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Neurally mediated syncope and syncope due to autonomic failure: differences and similarities
1Department of Neurology, Mount Sinai School of Medicine, New York, New York 10029, USA.
Summary
Syncope, a brief loss of consciousness, can stem from autonomic failure or neurally mediated syncope due to impaired blood flow to the brain. This review details neurally mediated syncope, differentiating it from autonomic failure.
Area of Science:
- Cardiology
- Neurology
- Autonomic Neuroscience
Background:
- Syncope is a transient loss of consciousness caused by reduced brain blood flow.
- Autonomic cardiovascular control abnormalities can lead to syncope via autonomic failure or neurally mediated syncope.
- Autonomic failure involves chronic sympathetic impairment, causing persistent orthostatic hypotension and syncope.
Purpose of the Study:
- To review the characteristics of autonomic failure.
- To detail the pathophysiology, diagnosis, and treatment of neurally mediated syncope.
- To distinguish between autonomic failure and neurally mediated syncope.
Main Methods:
- Literature review of autonomic failure.
- Detailed review of neurally mediated syncope pathophysiology.
- Analysis of diagnostic criteria and treatment strategies for neurally mediated syncope.
Main Results:
- Autonomic failure is characterized by chronic sympathetic dysfunction and consistent orthostatic hypotension.
- Neurally mediated syncope involves episodic sympathetic failure and hypotension triggered by specific events.
- Patients with neurally mediated syncope exhibit normal blood pressure and orthostatic tolerance between episodes.
Conclusions:
- Neurally mediated syncope is distinct from autonomic failure, presenting episodically.
- Understanding the triggers and pathophysiology is key for diagnosing and managing neurally mediated syncope.
- Effective treatment strategies exist for neurally mediated syncope, focusing on trigger avoidance and medical management.